If I were more self-aware would I be a better practitioner, more clinically adept, a more productive professional?
If I could manage myself better would I be a better practitioner, more clinically adept, a more productive professional?
If I were more socially aware would I be a better practitioner, more clinically adept, a more productive professional?
If I managed my relationships better would I be a better practi-tioner, more clinically adept, a more productive professional?
The answer to each of these questions must be an unequivocal yes. Taken together, each of these personal aspects—self-awareness, self-management, social awareness, and relationship management— constitutes emotional intelligence. This section focuses on increas-ing your level of emotional intelligence for the express purpose of increasing your professionalism, elevating your understanding of your clinical responsibilities, and making you a more productive and effective practitioner at work.
Desired Educational Outcome• List the concepts related to self-directed learning.
Desired Personal Outcome• Become adept at self-directed learning and developing personal
learning plans.
What’s the Typical Approach to Pharmacy Education?
In the familiar ways, schools of pharmacy train students to assimi-late and recall specific facts, calculate correct answers, and demonstrate
mastery of specific skills and techniques. Schools of pharmacy can also train students to demonstrate clinical judgment and problem solving. The approach used to do this, at most schools, is termed pedagogy. Pedagogy is the art and science of teaching children. (This is not to demean students; it simply reflects the definition and what actually goes on.) This approach assumes that students have dependent personalities, learning is subject motivated, motivation is extrinsic, and prior experience is not relevant. The extrinsic motivation for this process is the carrot of a degree and licensure. Obtaining licensure is no small thing. For the acquisition of the technical and procedural aspects of pharmacy this approach is time honored and rea-sonably effective, especially if licensure is the primary objective. However, as a practical matter, relatively little of this information is retained for sig-nificant amounts of time.
What Happens as Students Age?
At 23–25 years of age, most pharmacy students are taking on the characteristics of adult learners. Educating adult learners requires
different assumptions and a different approach to instruction. That approach is termed andragogy—the art and science of helping adults
4 chapter 1 z Self-Directed Learning
learn. The assumptions for adult learners are (adapted from Taylor & Kroth, 2009):
• Self-concept: As a person matures they move from being a dependent personality to being self-directed. As such, anything that is viewed as being forced on them will be resisted.
• Experience: As a person matures they have a backlog of experiences. These experiences are a resource for learning.
• Readiness to learn: As a person matures, readiness to learn is a function of the perceived relevance of the topic.
• Orientationtolearn:Adults learn those things that will help them solve a problem in real life.
• Motivationtolearn: With maturity, internal motivation is the key to learning.
• The need to know: With maturity, people need to know why they need to know something.
Accepting that these assumptions apply to pharmacy students, the approach to their education should reflect these assumptions.
What’s the Best Way to Enhance Professionalism?
Note that in this section we use the term professionalism as an umbrella term for emotional intelligence, professionalism, clinical
responsibility, and work. The same technique of self-directed learning will be applied to each of these areas.
If the educational approaches that worked earlier in their careers will not work, and recognizing that educating for professionalism differs from the typical pharmacy topics, then what is the best approach? The following are critical steps in professional education:
• To borrow from the book TheLessonsofExperience on the devel-opment of managers, “The primary responsibility for effective man-agement development resides in the managers themselves” (McCall,
What’s the Best Way to Enhance Professionalism? 5
1988, p. x). The author terms this fact the “gut truth.” It is possible for a pharmacy student to have the academic prowess to master the curriculum, complete clinical rotations, and pass the boards without ever addressing any deficiencies in professionalism, as long as they meet some minimal standard. The “gut truth” is that legitimate pro-fessional growth will be up to the student.
• Next is a change in mindset. If you don’t think professionalism can be increased then you see it as a fixed aspect of yourself, like your height. If you think professionalism can be increased then you see it as akin to increasing the size of a muscle—all you need to do is exercise.
• Goals come in two varieties. One goal is a performance goal, that is, to get the required grade to pass any formal course. A second and more powerful goal is a learning goal, to actually learn the material and become a professional.
• No two students will need to improve their professional development in exactly the same way. Students will be deficient in both kind and degree of professional behavior. Thus, a one-size-fits-all approach to professional development won’t work. As young adults, students will learn only what they want to learn. Under coercion, any behav-ioral changes shown will quickly be extinguished. Sustainable per-sonal change endures only if the individual wants it to. Self-directed change is intentional and conscious, a progression from who you are to who you want to be (Boyatzis, 2002). Self-directed learn-ers are characterized as curious, motivated, disciplined, methodical, reflective, self-aware, persistent, responsible, and self-sufficient with highly developed information-seeking skills and critical thinking abilities (Litzinger, Wise, & Lee, 2005).
• Not all students learn in the same manner. Some students’ pro-fessional behavior may be altered by association with a colleague, others will need to read something, and others may need to talk to someone. How something is learned doesn’t matter. What needs to be understood is that each student will vary in how they do it. Further, some students may get the “picture” almost overnight, whereas some may take years. The point is that all students are dif-ferent, and their learning styles and capacities vary.
chapter 1 z Self-Directed Learning6
• Mastering professionalism is painful. Nothing worthwhile is ever acquired without effort. Effort gives meaning to our lives. This task is just like acquiring clinical expertise—if it were easy everybody and anybody would do it. Think of any skill you have acquired in your life: a sweet golf swing, learning to play an instrument, riding a bike, organic chemistry. When asked the best way to get to Carnegie Hall, the musician replied, “Practice.” Being a professional requires prac-tice. You have to be willing to lean into the discomfort. “Learning to become an effective self-directed learner is probably the greatest intellectual and psychological challenge that an individual can face in a lifetime” (Dealtry, 2004, p. 108).
• There is no express elevator to the pinnacle of professionalism. It requires commitment to a process of gradual improvement. Think of how a foreign language is mastered. Day after day, vocabulary, idioms, grammar, and the rules of syntax are acquired. Profes-sionalism is similar. Gradually, the attitudes, values, and behaviors that constitute professionalism are recognized, understood, assim-ilated, and then woven into the pattern of our practice. No one loses 100 pounds in a day; people lose 1 pound 100 times over an extended period. Small wins in the pursuit of professionalism are the order of the day.
• No one is ever completely and consistently or perfectly professional. There is always something more to be learned. The pursuit of profes-sionalism is like an asymptote in algebra. An asymptote is a curve that approaches, but never touches, a straight line. On your last day of work, 40–50 years in the future, there will be some aspect of your pro-fessionalism that can be improved. Professionalism is not a dichoto-mous variable (either/or) but a continuous variable (more/less).
In summary:
• Legitimate professional growth is up to the student.
• Alter your mindset to recognize that professionalism can change.
• Establish mastery as a goal.
• Recognize you will direct your own program of professional growth.
• Determine the best way for you to learn.
What’s the Best Way to Enhance Professionalism? 7
• Lean into the discomfort.
• Small wins are the order of the day.
• Understand that you will never be perfect at this.
Personal change is hard. Think of the times in your life you vowed to improve some aspect of your behavior—study more, eat better, exercise more. Consider the outcomes. To be more emotionally intelligent and more professional is to engage in personal change. Telling a student to be more pro-fessional, be more self-aware, read this code of conduct, or attend this semi-nar doesn’t work. Hard as they might be, mastering the typical pharmacy school theories, concepts, and techniques are nothing compared to the task of mastering yourself and creating your professional identity.
What Are the Mechanics of Enhancing Professionalism?
Enhancing professionalism is an exercise in self-science and can be thought of as a self-oriented and self-directed experiment. As such,
it helps students to think of themselves as laboratory rats. Imagine look-ing down on yourself, as if you are in a maze. What are my tendencies and patterns, when do they emerge, what are the circumstances, with whom do they emerge, what am I feeling, what am I thinking, what is happening with my body, and so on? Essentially, you are trying to develop an objective data-base that captures your modus operandi for navigating the world around you. It is from this self database that a personal professionalism project emerges. Feedback of any type is a rich source of information in developing this personal database.
From this personal database, one can begin to formulate an area of professionalism for enhancement. A key consideration in developing these plans is that the aspect for professional enhancement be as targeted as pos-sible. Time and care must be spent in sharpening the focus. For a particu-lar student, the general area may be linked to relationships with others. To make it more specific, the student focuses on a tendency to anger when under stress and the potential harm to relationships. More specifically, she could focus on the anger associated with long lines at the drive-up win-dow, or even more focused, the anger at the long lines on a night before an
chapter 1 z Self-Directed Learning8
exam and the way this anger clouds her relationship with an older, female, high school–educated technician. Think of this process as an inverted fun-nel moving from the general to the specific. This approach is analogous to developing any good scientific experiment in that developing a focused, testable hypothesis is key. Thus, a student may undertake to understand what causes technicians in the circumstances just described to lose their composure. This is a long way from saying “be more professional.”
The mechanics of enhancing professionalism center on developing a personal learning plan. The essence of a personal learning plan is that the student self-identifies that aspect of professionalism they want to address. The student then identifies and implements unique activities and develops or acquires products and resources to address their particular issue. Next, the type of evidence that will be used to determine whether goals have been met are declared. Finally, a timeline for completion is determined. Once the process has been completed, the student should reflect on the process and the outcome. A personal learning plan format is presented here.
Personal Learning Plan: Professionalism
These steps can be compiled on a single page containing the following:
What prompted me to develop this plan?
What is the general area for improvement?
What is the specific issue for improvement?
Why is this important to me?
How do I generally act in these areas?
What are my goals?
What prompted this effort?
What strategies are required?
Who/what is necessary to meet my goals with this strategy?
How will I measure the success/failure of this effort?
How long will I focus on this effort?
How will I reflect and capture a lesson from this effort that can be generalized to other circumstances?
Personal Learning Plan: Professionalism 9
Self-Directed Learning Readiness Scale
Please record your response for each question using the following scale:1 5 strongly disagree; 2 5 disagree; 3 5 neither agree nor disagree; 4 5 agree; 5 5 strongly agree
1. I solve problems using a plan.
2. I prioritize my work.
3. I like to solve (answer) puzzles/questions.
4. I manage my time well.
5. I have good management skills.
6. I set strict time frames.
7. I prefer to plan my own learning.
8. I prefer to direct my own learning.
9. I believe the role of the teacher is to act as a resource person.
10. I am systematic in my learning.
11. I am able to focus on a problem.
12. I often review the way pharmacy practices are conducted.
13. I need to know why.
14. I critically evaluate new ideas.
15. I prefer to set my own learning goals.
Higher scores indicate a higher level of readiness for self-directed learning.
Source: Fisher, M., King, J., & Tague, G. (2001). Development of a self-directed learning readiness scale for nursing education. NurseEducationToday, 21, 516–525.
EXERCISES
chapter 1 z Self-Directed Learning10
Identifying Areas for Enhancing Professionalism
For some students, determining an area for professional growth and developing the process may be difficult. Several methods for making this determination are presented here.
Boyatzis’ Theory of Self-Directed Learning
Discovery No. 1: My Ideal Self: Who do I want to be?
Discovery No. 2: My Real Self: Who am I?
Strengths: Where are my ideal and real selfs similar?
Gaps: Where are my ideal and real selfs different?
Discovery No. 3: My learning agenda—building on my strengths while reducing gaps.
Discovery No. 4: New behavior, thoughts, and feelings through experimentation. Creating and building new neural pathways through practicing to mastery.
The key aspect of this model is to recognize the gaps, or deficiencies, in where you are and where you want to be.
Source: Adapted from Boyatzis, R. E. (2002). Unleashing the power of self-directed learning. In Ronald R. Sims (Ed.), Changingthewaywemanagechange:Theconsultantsspeak (pp. 13–32). Westport, CT: Quorum.
Emotional Intelligence Framework
Emotions convey information about ourselves and the world. Emotional intelligence is the ability to understand our emotions and those of another person, and then craft an effective behavior appropriate to the task. Tuning in to our emotional world and the emotional world of others spotlights areas for professional growth. Methods for highlighting areas for professional growth using emotional intelligence are suggested here.
Strongestemotionalreaction: Identify the strongest emotional reaction you have experienced during school, on rotations, or at work. Describe the context, the circumstances, the people involved, what you were feeling, how you behaved, and the outcome.
11EXERCISES
Hotbuttons: What circumstances, activities, and people cause you to lose your composure? The times that you “lost it” are areas for profes-sional growth.
Fears: Think of the aspects of practice that frighten you.
The key assumption with this approach is that any area that elicits a strong emotional reaction or frightens you is a fertile area for exploration and improvement.
Appreciative Inquiry
Appreciative inquiry is based on the recognition that all of us are particularly good at something, and what we focus on becomes our reality. Focusing on our deficiencies becomes our reality. In contrast, asking questions of our-selves highlights what we are good at. We then spend more of our effort in doing this, rather than attempting to correct deficiencies. So, how do you get better if you only focus on what you are good at? Recognizing you are good at certain things helps you develop the confidence and comfort to move to areas for improvement. Anchored in the knowledge that you are good at something, you can bring more of the same to areas you want to strengthen.
Appreciative inquiry questions:
1. Think of an aspect of professionalism that is a strength, something you are good at and noted for by others.
2. Think of a current situation involving your professional behavior, and consider a new way of perceiving it. a. What is good about this situation, what can I appreciate?b. What do I really want?c. What am I focusing on? Can I shift my focus?d. What learning is available to me, and how can I open up to it?
This approach asks you to consider things you are good at and then extend and leverage those strengths to other areas.
Source: Adapted from Kelm, J. B. (2005). Appreciativeliving. Wake Forest, NC: Venet.
chapter 1 z Self-Directed Learning12
Learning History
Adult education assumes that as a person matures they have a backlog of experiences. These experiences are a resource for learning. The question is how to record these experiences and then access the relevant lessons. A personal learning history accomplishes this task. The process of writ-ing a personal learning history is simple. First, on a piece of paper create a two-column table. In the left column record a narrative, the story of what happened; for example, the story of your first clinical rotation. Write the story from your perspective; however, if you are aware of other people’s points of view, incorporate these also. In the right column analyze what happened, looking for patterns and areas for improvement. The material in the right column becomes the focus of your personal learning plan. Having someone else read your learning history will confirm the validity of your interpretation of events.
Critical Incident Reports
A refinement of the learning history is the development of a critical inci-dent report and reflection on its meaning. A critical incident report is a short, narrative story of a specific event you judge to have significant importance in your professional development. A critical incident can be a learning experience, a challenging occurrence, a personally influential event, or something you witnessed. In developing these reports, think of yourself as a Monday morning quarterback critiquing your performance for the past week. Capturing the incident is the first part of the process; reflection on the meaning of these incidents is also required.
Describe an incident that was particularly meaningful to you.
Describe a professional relationship that was particularly meaningful to you.
Describe a patient relationship that was particularly meaningful to you.
Based on your responses to the exercises, write a one-paragraph description of yourself as it relates to self-directed learning.
13EXERCISES
What’s Important to You in This Chapter?
With several of your classmates, discuss the idea or ideas that are most likely to be helpful to you in developing a self-directed learning program for yourself.
ReferencesBoyatzis, R. E. (2002). Unleashing the power of self-directed learning.
In Ronald R. Sims (Ed.), Changing the way we manage change:Theconsultantsspeak (pp. 13–32). Westport, CT: Quorum.
Dealtry, R. (2004). Professional practice: The savvy learner. Journal ofWorkplaceLearning, 16, 101–109.
Fisher, M., King, J., & Tague, G. (2001). Development of a self-directed learning readiness scale for nursing education. NurseEducationToday, 21, 516–525.
Litzinger, T. A., Wise, J. C., & Lee, S. H. (2005). Self-directed learning readi-ness among engineering undergraduate students. JournalofEngineeringEducation, 94(2), 215–221.
McCall, Jr., M. W., Lombardo, M. M., & Morrison, A. M. (1988). Thelessonsofexperience. Lexington, MA: Lexington.
Taylor, B., & Kroth, M. (2009). Andragogy’s transition into the future: Meta-analysis of andragogy and its search for a measureable instrument. JournalofAdultEducation,38(1), 11.
Suggested ReadingsAmabile, T. M., & Kramer, S. J. (2011, May). The power of small wins.
HarvardBusinessReview, 71–80.Branch, W. T. (2005). Use of critical incident reports in medical education.
JournalofGeneralInternalMedicine,20, 1063–1067.Challis, M. (2000). AMEE medical education guide no. 19: Personal learning
plans. MedicalTeacher, 22(3), 225–236.Chan, S. (2010). Applications of andragogy in multi-disciplined teaching
and learning. JournalofAdultEducation, 39(2), 25–35.
chapter 1 z Self-Directed Learning14
Dweck, C. S. (2000). Self-theories. New York, NY: Taylor and Francis.Dweck, C. S. (2006). Mindset. New York, NY: Ballantine.Gardner, H. (2006). Changingminds. Boston, MA: Harvard Business School
Press.Glasser, W. (1976). Positiveaddiction. New York, NY: Harper and Row.Hammond, S. A. (1998). Appreciativeinquiry. Bend, OR: Thin.Hilliard, C. (2006). Using structured reflection on a critical incident to
develop a professional portfolio. NursingStandard, 21(2), 35–40.Kelm, J. B. (2005). Appreciativeliving. Wake Forest, NC: Venet. Kleiner, A., & Roth, G. (1997, September–October). How to make experi-
ence your company’s best teacher. HarvardBusinessReview, 172–177.May, N., Becker, D., Frankel, R., Hazlip, J., Harmon, R., Plews-Ogan, M.,
Schorling, J., Williams, A., & Whitney, D. (2011). Appreciativeinquiryinhealthcare. Brunswick, OH: Crown Custom.
Seligman, M. E. P. (2007). What you can change . . . andwhat you can’t. New York, NY: Vintage.
